NPI | 1518158633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 201201684) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 201201684) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2021-09-22 |